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Annals of Clinical Biochemistry

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First published on 13 November 2008, doi:acb.2008.008123
Annals of Clinical Biochemistry 2009;46:33.
A more recent version of this article appeared on January 1, 2009
© 2008 Association for Clinical Biochemistry

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Original Article

Development and validation of an improved test for the measurement of human faecal elastase-1

Petros Kampanis, Loretta Ford and Jonathan Berg


Department of Clinical Biochemistry, City Hospital, Dudley Road, Birmingham B18 7QH, UK


Corresponding author: Dr Petros Kampanis. Email: Petros.Kampanis{at}swbh.nhs.uk

Background: Human faecal elastase-1 (FE-1) is an established biochemical test for the investigation of pancreatic exocrine insufficiency. Conventional extraction methods for FE-1 analysis can give false-positive results with watery stools. This is a major limitation as patients investigated for pancreatic disease commonly produce such stools. We have developed an improved FE-1 test that overcomes water interference by measuring the enzyme in dried faeces.

Methods: A novel collection device for FE-1 analysis that involves drying and weighing the stool sample was developed in our laboratory and compared with a conventional wet method, E1 Quick-Prep (Schebo, Biotech AG, Germany). The concentration of faecal FE-1 was determined using a commercially available enzyme-linked immunosorbent assay method (Schebo).

Results: FE-1 values obtained using the new dry extraction procedure (mean 1777 µg/g dry stool) were higher when compared with the conventional wet analysis (mean 402 µg/g stool). A 1:2 dilution in water, mimicking a loose stool, was found to affect FE-1 results obtained using the conventional wet extraction procedure. The new dry extraction method gave consistent results when water content was varied in the original stool sample.

Conclusion: We have demonstrated that our new device overcomes water interference, allowing results to be obtained from stool samples that would otherwise be unsuitable for FE-1 analysis.


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